We have split our FAQs into sections below – please have a read and see if we have already addressed your query.
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CogMission and Dr Bredesen
Where is the connection, and how do we work together to provide Alzheimer’s support in the UK?
Who is Dr Bredesen?
Dr Dale Bredesen is internationally recognised as an expert in neurodegenerative diseases including Alzheimer’s and Dementia. He earned his MD from Duke University Medical Centre in North Carolina, served as Chief Resident in Neurology at USCF and has held faculty positions at UCLA and the University of California.
He founded the Buck Institute for Research on Aging in 1998, and The Bredesen Protocol is a scientifically-based program designed to identify and remedy the causes of Alzheimer’s and Dementia.
Are CogMission connected to Dr Bredesen? How?
Our Clinic Directors Charmaine and Jean learned about Dr Bredesen’s work a few years ago, and were both amazed and skeptical.
After looking more closely into Dr Bredesen’s published research, they were impressed, and decided to attend Dr Bredesen’s training for medical professionals in California in 2017.
Since meeting Dr Bredesen and his team for a second time earlier this year at a London conference, Team CogMission have kept in close contact with Dr Bredesen’s first accredited clinics over in the states, in order to develop a way to bring this revolutionary treatment program and knowledge to patients in Scotland, the UK and beyond.
Who is the Bredesen Protocol for?
The Bredesen Protocol is for anyone concerned about cognitive decline.
It is for your elderly parent whose age makes them possess high risk of developing dementia. It is for your friend in their 40s who knows (or suspects due to family history) that they have ‘The Alzheimer’s Gene’ and wants to know what they can do now to prevent problems in the future. It is for the otherwise healthy person in their 60s who wonders if their brain is still working ‘well’ and if there is something they can do to get their memory back how it used to be.
To put it bluntly and literally, The Bredesen Protocol is for anyone with a brain!
Why have I never heard of the Bredesen Protocol until now?
It always seemed like such bad news when Alzheimer’s was involved, with headline after headline describing more drug trial failures – 99.6% of what we have tried, has failed, and the 0.4% doesn’t effectively reverse symptoms, it just makes them a little more bearable for a limited time.
Dr Bredesen published his first study results in 2014 with a paper on the novel therapeutic program called MEND (Metabolic Enhancement for Neurodegeneration). Since then, the therapeutic program has been developed into the more advanced ReCODE protocol (Reversal of Cognitive Decline). In a 2016 paper, Dr Bredesen’s team published their first ten case studies and results for the MEND project, with a reversal of symptoms in 9 of the participants.
Why did we not hear about this?
Well, it wasn’t for lack of trying!
Back in 2011, the research was becoming the basis for an entire list of interconnected causes for dementia (rather than just one or two). Team Bredesen had compiled a list of no less than 36 molecular mechanisms which they strongly believed contributed to Alzheimer’s. The next step would be a clinical trial to test and confirm what they had already discovered in the laboratory.
How do you get permission to do a clinical trial in the US?
Well, you’d need initial preclinical trials (testing on animals), then stage one testing, then stage two (slightly more people), then stage three with hundreds or thousands of patients.
Then, if it’s all looking good, the Food and Drug Administration will approve the drug so that it can begin to be sold, in a process which can take decades and cost billions.
Have you spotted the sore point, yet?
This process is for testing just one drug. Dr Bredesen and his team wanted to test their strategy for managing 36 different issues, not just one. Their application to run clinical trials failed, they were told that there was no way you could do a clinical trial for a programme of varied treatments rather than a single pill.
The success of the programme has developed a little slower as a result. In a way, The Bredesen Protocol as a treatment method has been proven more organically, by word of mouth. Tiny groups of people, often going through debilitating cognitive decline at a far younger age than usual, were at their wit’s end, and the Bredesen Protocol wasn’t just an answer. For them, and fellow dementia-sufferers, it is a solution.
I am worried because my parents and grandparents developed early-onset Dementia. Could the Bredesen Protocol help me?
We can help you by helping you access the latest information and testing processes to monitor your brain health and be proactive now.
The first step would be a cognoscopy – a little like a brain MOT.
The Cognoscopy gives you a snapshot of where you stand at the current moment in terms of cognitive health. A computerised test will measure your cognitive performance, and a comprehensive set of laboratory measures give us measurable results of your overall health and risks.
We would also establish what (if any) genetic risk you had of developing early onset Alzheimer’s and then work closely with you to develop a complete lifestyle plan, designed around your results, to put you in control of your brain health and teach you how to reduce your risk.
We can advise you on nutrition and diet, provide personalised supplement plans to naturally support your brain function, and answer your questions as and when they arise.
This process is a little different from the way we are used to being treated – using a pill for every ill.
One of our own CogMission clients agreed to share his story on our website so feel free to read that next.
What do I need to know about CogMission before I enquire? What is the process really like?
What is ReCODE and why must I sign up?
ReCODE stands for Reversal of Cognitive Decline, and it is the term we use to describe the way we measure and report your brain health, if you are already experiencing significant cognitive issues.
The ReCODE report is generated from a specific set of lab tests, designed to figure out exactly what your brain health looks like now, and where changes need to be made. The goal isn’t just to get your ReCODE results a little better, it’s always to optimise them.
The ReCODE test is unique and highly detailed, and it also requires software designed by Dr Bredesen and his team to interpret and understand the results properly in the context of the 36 molecular mechanisms connected to dementia. It uses algorithms and complex data to analyse your results, allowing your medical practitioner to assess your biochemical needs.
That’s why part of our process at CogMission will always include the need to sign up for ReCODE – we use these reports and systems to monitor and track your brain health.
How many tests do I need to do when I get started?
The initial testing is made up of blood tests, computer-generated cognition tests (or a MOCA) and a session with our clinic directors to gather as much information about your family history as possible.
80% of cases will reveal expected patterns after those three sessions are complete, so that we can start building your unique treatment program.
However, sometimes our initial blood tests and cognition tests (we call this our cognoscopy) and our family history collection session still reveal uncertainties in the cause of your cognitive symptoms, and we will have to arrange more detailed tests to get to the bottom of it.
If this is the case, we will be transparent at each stage regarding timescale and price.
How long will I need to follow the protocol to see results?
It is very important to appreciate that this protocol is a life-long commitment.
Over and over again in the case studies, patients achieve brilliant results when they follow this protocol, and symptoms return only when they stop following it.
It is also important to understand that the protocol doesn’t just consist of a few pills.
It is a lifestyle change – diet, exercise, supplements. We believe it is entirely worth it to regain a quality of life that cognitive decline often robs you of, but we won’t deny it’s sometimes challenging to change your lifestyle! Most people when they see the benefits will be motivated to continue.
We will always be ready to support you as long as you are willing to try.
What happens if I’m not happy with my treatment results after 6 months?
Currently, there is no proven cure for Alzheimer’s and Dementia.
With the Bredesen Protocol, we don’t have a proven cure but we do have real case studies with real results.
We see the patient who is able to go back to work after developing early-onset cognitive decline in their 50s, previously seriously concerned about being able to keep up in a highly analytical job.
We meet with the children of couples in their 80s who are excited to report how much better their parents are doing
We’ve got great experience and a lot of passion. Usually, we would expect to see signs of improvement after 3-6 months, or at least evidence that the symptoms have not worsened in that period.
If we aren’t seeing results, then it means that something has been missed or there is a compliance issue, and we need to go back to the drawing board.
We expect to work with our patients over a long and fruitful period of time, so we will not hesitate to re-do tests, analyse further and consult the latest findings in order to help you relieve your symptoms of cognitive decline.
Will I need to change my diet? I already eat well.
We recommend the ketoflex diet, and we will help you to create the optimal version for you.
There is no single diet which is optimal for every person, each body may require a slightly different approach. We will work with you and our expert nutritionist to figure out what type of diet would help your cognitive health.
The gut is a huge part of your brain health – a 2018 study found that the vagus nerve connects the gut and brain, sending signals in both directions. If you have problems in your brain, you will certainly have problems in your gut health too, whether you’re aware of them or not.
A ketogenic diet is high in (certain) fats, and low in carbohydrates. If you aren’t familiar with the benefits of this kind of diet, then it is likely to seem a little strange to you at first!
Every patient will meet with our expert nutritionist, Jackie, for the first 3 months (either in person or over Skype if this is easier for you) to discuss your diet, assess any difficulties you are having, and just get tips on the practicalities of how to cook and eat well on a ketogenic diet!
You can read Jackie’s notes on the ketoflex diet here.
Can you tell me a bit more about herbal medicine?
Herbal medicine has a long and safe traditional history of usage and today’s herbalist are very carefully self regulated. The National Institute of Herbal Medicine was started in 1864 and is the United Kingdom’s leading professional body and voluntary regulator of Herbal Practitioners.
Medical Herbalists make use of plants with traditional uses, backed up by modern scientific research and clinical trials. A qualified Medical Herbalist has a B.Sc. or equivalent in Herbal Medicine, has studied orthodox medicine as well as plant medicine and is trained in the same diagnostic skills as a GP. Herbalists, however, take an holistic approach to illness, treating the underlying cause of disease rather than just the symptoms. They are able to prescribe herbal medicines to be used safely alongside other medications and treatments.
Herbal medicines are plant-based medicines made from differing combinations of plant parts, e.g. leaves, flowers or roots. Each part can have different medicinal uses and the many types of chemical constituents require different extraction methods. Medical Herbalists are very aware of the importance of medicines being sourced from reputable manufacturers who maintain consistent quality standards. Traceability (right back to the original batch of herbs) and certificates of authenticity are key ways in which quality is maintained. Sustainability is also of crucial importance.
The crucial element of herbal medicine is the ability to produce specialised individualised blends of medicine that are able to be adapted visit by visit as the patient improves. This fits in perfectly with the individualised approach by Dr Bredesen.
I had some tests done recently and they were all normal - can I still get tested with you?
Even if you have had a full blood test recently, the kind of things we check for are not typically measured in a test ordered by your GP.
The other thing to remember is that we aren’t just looking to get your body into a ‘normal’ range for any one thing… we want to optimise to get the best results for you.
‘Normal’ levels in a regular blood test might cover up small changes in ratios that we need to know about in order to create the most effective treatment program for you.
How do you do blood testing? Do I have to travel to Edinburgh?
If you’re near Edinburgh, we will carry out the blood tests required. Anywhere else in the UK (or beyond!) and we will assist you to find a suitable phlebotomist who can visit you, complete the tests and send them off to the labs we work with.
We are aware that some patients suffering cognitive decline might struggle with travelling and going to new places for testing, so we want to make this process as simple for you as possible. Don’t hesitate to reach out if you have worries about this aspect of treatment.
What happens in my first consultation meeting? How long is it? If it’s for my parents, can I come, too?
Your first consultation meeting takes place with Charmaine and Jean, and it will be 90 minutes. Our intention here is to write a case history – to gather all the data and also take the time to get to know the patient in detail.
We welcome family members, as the more information we can gather about the history of health and lifestyle, the better!
We appreciate that the nature of cognitive decline means that some patients may struggle to work through and oral case history, so we recommend that you bring as many relevant documents as possible, and we will comb through them together to build a picture of the patient’s health.
How much will it cost to get started?
There is a detailed pricing list in our Brain Health Handbook which you can download for free. On average, the first three months will cost £500 pcm, months 4-6 will cost £400 pcm and thereafter there is a monthly charge of £250 pcm for ongoing monthly contact time and support.
Please note that the above prices do not include:
- Functional testing (except for in the first month, where the fee includes testing)
- Herbal medicines (usually about £40-50 pcm but depends on each patient)
- Subscription to the ReCODE computer testing program (essential for managing results, about £60 pcm according to current prices and exchange rate – this service is provided by Dr Bredesen’s team)
Why is the protocol more expensive to get started than it is to maintain?
We have a lot of work to do in the first few months, and our prices reflect that.
Whilst we always arrange to see patients once a month and allow for unlimited contact time in-between as needed, the first few months with a new patient mean a lot more time analysing all their results, figuring out the best course of action and adjusting as necessary. After 6 months, we would expect a patient to feel much more stable with reduction in symptoms, so it is more a case of maintenance and regular testing to check everything is still being managed by the protocol that we have specifically recommended for you.
What kind of support can I expect after I start working with CogMission? Will it go on longer than a few months?
When people stop following the protocol, their symptoms get worse again. That’s the one thing we see time and time again, and it is recorded in Dr Bredesen’s case studies, too.
We care very deeply about all of our patients and we want to keep seeing you to ensure that we are doing everything we can to support you and your health. The cost for ongoing maintenance appointments and support is £250 pcm, plus the cost of ReCODE subscription and any herbal medicines required (see above for prices).
This involves monthly meetings with the clinic directors and nutritionist, unlimited contact time to deal with any issues which may arise, and we are always happy to regularly review your plan and care, both in line with your experience and with the latest research in the field.
If you want to stay with us, we’d be honoured to have you!
I want to bring my parent/relative in to see you, but their illness makes it really difficult to bring them to new places. Is there a way to start treatment without coming to Edinburgh every month?
We completely understand that the nature of cognitive decline means patients often struggle with leaving the familiarity of home, and we are fully flexible to help you get the treatment you need.
Our comfortable and welcoming clinic is near Haymarket train station in Edinburgh. Treatment areas are fully accessible, we prioritise comfort and quiet and if you have any particular requirements for access then please do not hesitate to ask – we are happy to help.
If you feel that bringing the patient in would be too stressful, then we can also use technology to bridge the gap. We are happy to conduct one-to-one meetings with clinic directors and nutritionists over Skype or Facetime, and perhaps only meet in person every so often, if at all.
Please don’t let distance deter you as we are able to support you using other means if necessary.